No science? No worries

If you ever wanted to be a doctor, but were scared off because of all the science you would have to learn, you may soon be in luck. Canadian medical schools are taking a closer look at their admissions practices, and prerequisites like the much-feared Medical College Admissions Test (MCAT) are no longer seen to be as imperative as they once were.

Just how picky medical schools should be about students being well-versed in the scientific foundations of human anatomy is a decades-old debate. But now, lacking a solid grasp of science might not be a barrier to getting that white coat.

For 25 years, Mount Sinai School of Medicine in New York has reserved around 30 spaces for students who haven’t taken physics, calculus, organic chemistry or the MCAT. A recent study on the Mount Sinai program, co-authored by the school’s dean emeritus Nathan Kase, concluded that students admitted through the humanities and medicine stream “performed at a level equivalent to their premedical classmates.”

In Canada, there are already two medical programs, McMaster University and the Northern Ontario School of Medicine, that have no science requirements, either through course prerequisites or the MCAT. Several others are reviewing their core application requirements.

The University of British Columbia is undergoing a curriculum review that could see a revamping of at least one first-year medicine course so that it no longer presumes an extensive science background. According to Joseph Finkler, associate dean of admissions for medicine, that could open the door to revising the selection process. “It is possible that we will end up with multiple admissions streams, including one without the prerequisites and MCAT,” he said. Lewis Tomalty, Queen’s University’s vice-dean, medical education, says that while some science is “necessary,” encouraging students with a range of academic backgrounds to apply is beneficial to the classroom. “We’re looking at how extensive [science prerequisites] have to be and are certainly looking to change the actual admissions requirements,” he said. Similarly, the Université de Montréal has put a committee in place to review whether its list of science requirements creates an unnecessary barrier to pursuing a career in medicine.

But the school that is farthest along in this process is McGill University. In July, McGill announced that it would no longer require prospective students to take the MCAT. The faculty of medicine will also be reserving three spaces for “non-traditional” students, giving great weight to things like work experience. They will also be exempt from having to complete their first degree full-time, a common prerequisite intended to ensure students can handle the workload. Saleem Razack, assistant dean of admissions at McGill, says these policy changes are needed “so that the excellence that students with diverse life experiences can bring to the medical profession can be assessed and valued.”

The key is finding the right balance, says Miki Rifkin, who oversees the humanities and medicine program at Mount Sinai. While her students are exempt from most science prerequisites, they still have to take introductory chemistry and biology, and have an otherwise exemplary academic record. The goal is to encourage students who might otherwise be deterred at the prospect of the MCAT to pursue medicine. “We want to make a difference for students passionate about some non-science area,” she said.

“The older way of thinking is that doctors should be scholars and scientists first,” says Terry Wuerz, who earned his medical degree from the University of Manitoba in 2007. “I think it’s great that med schools are starting to recognize the different roles doctors play.”

There are, of course, hurdles to reform. Using the MCAT and having science prerequisites are very useful for sorting through thousands of applications. “How do you choose the ones you’re going to interview?” asks Tomalty. While Mount Sinai non-science students do well overall, they do struggle during their first two years, and perform less well on medical licensing exams.

This is consistent with the experience at Canadian schools, says Harold Reiter, chair of admissions at McMaster, but that doesn’t detract from the generally high performance of the non-science students, he said. “Once they have caught up, they do every bit as well as their science-background peers.”